Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf .... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 0 | 80,945 | 80,945 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 0 | 0 | 0 | 0 | 0 | 0 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | 0 | 0 | 0 | 0 | 0 |
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | 0 | 0 | 0 | 0 | 0 |
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | 0 | 0 | 0 | 0 | 0 |
| 6 | Total. Add lines 1 through 5 | 0 | 0 | 0 | 0 | 80,945 | 80,945 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | 0 | 0 | 0 | 0 | 0 |
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 7a and 7b.. | 0 | 0 | 0 | 0 | 0 | 0 |
| 8 | Public support. (Subtract line 7c from line 6.) | 80,945 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 0 | 0 | 0 | 0 | 80,945 | 80,945 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | 0 | 0 | 0 | 0 | 0 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | 0 | 0 | 0 | 0 | 0 |
| c | Add lines 10a and 10b. | 0 | 0 | 0 | 0 | 0 | 0 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | 0 | 0 | 0 | 0 | 0 | 0 |
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | 0 | 0 | 0 | 0 | 0 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 0 | 0 | 0 | 0 | 80,945 | 80,945 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2023 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
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| Part I, line 16 | | Other Expenses:, Amount:| DEBIT PURCHASE SAFEWAY #1495 CENTRALIA WA, $10.00| DEBIT PURCHASE SAFEWAY #1495 CENTRALIA WA, $23.00| DEBIT PURCHASE -VISA ACEITUNOS MEXICCENTRALIA WA, $11.00| DEBIT PURCHASE -VISA AMAZON.COM*HY2MOAMZN.COM BILWA, $76.00| DEBIT PURCHASE ROCHESTER LUMBERROCHESTER WA, $59.00| DEBIT PURCHASE LOWES #1167 OLYMPIA WA, $58.00| RECURRING DEBIT PURCHASE INSTANTNONPROFITHTTPSWWW.INSCO, $37.00| DEBIT PURCHASE -VISA AMZN Mktp US*HJ0Amzn.com bilWA Tree house toys supplies, $56.00| DEBIT PURCHASE -VISA AMZN Mktp US*HJ1Amzn.com bilWA - tree house toys supplies, $205.00| DEBIT PURCHASE -VISA AMZN Mktp US*HJ4Amzn.com bilWA, $50.00| RECURRING DEBIT PURCHASE INSTANTNONPROFITHTTPSWWW.INSCO, $37.00| DEBIT PURCHASE -VISA HOMEDEPOT.COM 800-430-3376GA, $310.00| DEBIT PURCHASE -VISA GOEBEL SEPTIC TA360-736-2167WA - Porta Potty, $400.00| DEBIT PURCHASE -VISA ROCHESTER LUMBER360-2735213 WA, $29.00| DEBIT PURCHASE WM SUPERC Wal-MaTUMWATER WA - Tonka trucks for gravel pit, $38.00| DEBIT PURCHASE TARGET T- 665 SlLacey WA - tonka trucks for gravel pit, $67.00| DEBIT PURCHASE BAILEYS IGA ROCHESTER WA, $11.00| DEBIT PURCHASE -VISA AMZN Mktp US*UE3Amzn.com bilWA, $49.00| DEBIT PURCHASE -VISA AMZN Mktp US*ZB7Amzn.com bilWA - Reading tent, $553.00| RECURRING DEBIT PURCHASE INSTANTNONPROFITHTTPSWWW.INSCO, $37.00| ATM WITHDRAWAL 9921 HIGHWAY 12 Rochester WAUS1 - Wood dutch door for play shed FB cash, $204.00| DEBIT PURCHASE -VISA CHEVRON 0207360 ROCHESTER WA - Gas to pick up door, $40.00| DEBIT PURCHASE -VISA AMZN MKTP US*3W8AMZN.COM BILWA, $171.00| DEBIT PURCHASE -VISA AMZN Mktp US*W98Amzn.com bilWA, $24.00| DEBIT PURCHASE -VISA WALMART.COM 800-966-6546AR - water jug, $33.00| DEBIT PURCHASE -VISA WALMART.COM 800-966-6546AR - changing tents for water fun, $208.00| DEBIT PURCHASE -VISA AMZN Mktp US*CW5Amzn.com bilWA, $108.00| DEBIT PURCHASE LOWES #1167 OLYMPIA WA - building supplies, $277.00| DEBIT PURCHASE -VISA PILOT_01169 TUMWATER WA - Gas to pick up cafeteria tables, $35.00| DEBIT PURCHASE -VISA ROCHESTER LUMBER360-2735213 WA - building supplies, $215.00| ATM WITHDRAWAL ALBERTSONS #407 TUMWATER WAUS1 - Cafeteria tables - FB Marketplace - Cash, $320.00| DEBIT PURCHASE -VISA AMZN Mktp US*PN3Amzn.com bilWA - water toys, $69.00| DEBIT PURCHASE -VISA AMZN Mktp US*247Amzn.com bilWA - water toys, $40.00| DEBIT PURCHASE -VISA AMZN Mktp US*202Amzn.com bilWA - water toys, $65.00| DEBIT PURCHASE -VISA AMZN Mktp US*G84Amzn.com bilWA - water toys, $215.00| DEBIT PURCHASE -VISA AMZN Mktp US*O28Amzn.com bilWA - Water toys, $54.00| DEBIT PURCHASE -VISA ROCHESTER LUMBER360-2735213 WA, $6.00| RECURRING DEBIT PURCHASE INSTANTNONPROFITHTTPSWWW.INSCO, $37.00| DEBIT PURCHASE CHEVRON M SHAH LROCHESTER WA - Gas in truck to pick up driving arcade, $30.00| ATM WITHDRAWAL ALBERTSONS #407 TUMWATER WAUS1 - Driving arcade FB market - cash purchase, $500.00| DEBIT PURCHASE -VISA CHEVRON 0306029 SEABECK WA - Gas in truck to pick up driving arcade, $34.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - pizza for teen night, $44.00| DEBIT PURCHASE -VISA AMZN Mktp US*WS8Amzn.com bilWA raspberry pies returned, $45.00| DEBIT PURCHASE -VISA SQ *LAELS LANDSCentralia WA, $22.00| DEBIT PURCHASE -VISA GOEBEL SEPTIC TA360-736-2167WA, $400.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - pizza for teen night, $33.00| DEBIT PURCHASE THE HOME DEPOT 4TUMWATER WA, $499.00| CUSTOMER WITHDRAWAL turf purchase from facebook market place - paid cash, $750.00| DEBIT PURCHASE -VISA TIN MEN SUPPLY I360-7368118 WA - Metal Siding barn, $1656.00| DEBIT PURCHASE 17624 SE 272ND SCOVINGTON WA - Gas to pick up the turf guy was no show, $36.00| DEBIT PURCHASE THE HOME DEPOT 4TUMWATER WA, $63.00| DEBIT PURCHASE -VISA DOMINOS 7054 360-919-0000WA - gluten free pizza teen night, $18.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - pizza teen night, $65.00| DEBIT PURCHASE -VISA CHEVRON 0203556 RIDGEFIELD WA - gas for truck to pick up Turf 2nd time, $27.00| DEBIT PURCHASE COSTCO GAS #0064TUMWATER WA - Gas to pick up Dutch door, $40.00| ATM WITHDRAWAL ALBERTSONS #407 TUMWATER WAUS1 dutch door for play shed - FB Market Cash, $200.00| DEBIT PURCHASE -VISA WALMART.COM 800-966-6546AR - Toddler town swing, $49.00| DEBIT PURCHASE THE HOME DEPOT 4LACEY WA, $51.00| DEBIT PURCHASE -VISA SP PARTYMACHINESHTTPSPARTYMATX, $1266.00| RECURRING DEBIT PURCHASE INSTANTNONPROFITHTTPSWWW.INSCO, $37.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - Pizza teen night, $44.00| DEBIT PURCHASE -VISA AMZN MKTP US*TA6AMZN.COM BILWA - teen arcade computer, $120.00| DEBIT PURCHASE -VISA AMZN Mktp US*TA5Amzn.com bilWA - warranty for computers, $38.00| DEBIT PURCHASE -VISA AMZN Mktp US*TA0Amzn.com bilWA - teen arcade computer, $120.00| DEBIT PURCHASE -VISA SQ *TACOS LA ESQOlympia WA - Dinner for board meeting, $87.00| DEBIT PURCHASE -VISA AMZN Mktp US*TO9Amzn.com bilWA, $44.00| DEBIT PURCHASE -VISA AMZN Mktp US*TO5Amzn.com bilWA, $11.00| DEBIT PURCHASE -VISA UNBROKEN SOFTWARHTTPSWWW.LAUCA - arcade software, $75.00| DEBIT PURCHASE -VISA SMARTSIGN 718-797-1900NY - swing and zipline weight limit signs, $199.00| ATM WITHDRAWAL US BANK LACEY LACEY WAUS1 - swing set FB market Cash Purchase, $400.00| DEBIT PURCHASE -VISA PILOT_01169 TUMWATER WA - Gas to go pick up swing set, $50.00| DEBIT PURCHASE -VISA SQ *LAELS LANDSCentralia WA - gravel for driveway, $2465.00| DEBIT PURCHASE -VISA GOEBEL SEPTIC TA360-736-2167WA - porta potty, $400.00| RECURRING DEBIT PURCHASE INSTANTNONPROFITHTTPSWWW.INSCO, $37.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - teen night pizza, $22.00| CHECK - Cross creek Alpaca rescue - Hay for animals, $940.00| DEBIT PURCHASE THE HOME DEPOT 4TUMWATER WA - building supplies, $93.00| DEBIT PURCHASE COSTCO GAS #0064TUMWATER WA - Gas to pick up hay and siding, $60.00| DEBIT PURCHASE WAL-MART #2249 CHEHALIS WA, $8.00| DEBIT PURCHASE -VISA ROCHESTER LUMBER360-2735213 WA - building supplies, $34.00| DEBIT PURCHASE -VISA ROCHESTER LUMBER360-2735213 WA - building supplies, $96.00| DEBIT PURCHASE -VISA U-HAUL STG OF CHCHEHALIS WA - Uhaul rental to pick up Hay, $41.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - teen night pizza, $54.00| DEBIT PURCHASE Wal-Mart Super CTUMWATER WA - teen night soda and chips, $27.00| DEBIT PURCHASE -VISA HOMEDEPOT.COM 800-430-3376GA - Lattice for play structure, $327.00| DEBIT PURCHASE -VISA ROCHESTER LUMBER360-2735213 WA - building supplies, $141.00| ANALYSIS SERVICE CHARGE - Bank service fee, $10.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - teen night pizza, $33.00| DEBIT PURCHASE -VISA U-HAUL STG OF CHCHEHALIS WA - Uhaul rental to pick up donated wood, $41.00| DEBIT PURCHASE -VISA END OF THE TRAILROCHESTER WA, $40.00| DEBIT PURCHASE -VISA DOMINOS 7176 360-807-6000WA, $16.00| DEBIT PURCHASE -VISA COSTCOCHECKS.COM877-534-3769TX, $57.00| DEBIT PURCHASE -VISA AMZN MKTP US*T92SEATTLE WA, $73.00| DEBIT PURCHASE -VISA AMZN MKTP US*T95SEATTLE WA, $52.00| DEBIT PURCHASE -VISA ROCHESTER LUMBER360-2735213 WA, $145.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - teen night pizza, $22.00| CHECK - Reimburse Russ Gibbs for part, $50.00| RECURRING DEBIT PURCHASE INSTANTNONPROFITHTTPSWWW.INSCO, $37.00| DEBIT PURCHASE -VISA INTUIT *QBooks OCL.INTUIT.COCA, $16.00| DEBIT PURCHASE TRACTOR S 6312 1Rochester WA - Medical supplies for Horses after attack, $146.00| DEBIT PURCHASE ROCHESTER LUMBERROCHESTER WA, $426.00| ANALYSIS SERVICE CHARGE, $10.00| DEBIT PURCHASE -VISA SQ *FLAMING PIG gosq.com WA - Dinner provided at Board Meeting, $115.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - Pizza for teen night, $54.00| DEBIT PURCHASE WAL-MART #3850 TUMWATER WA - Smores supplies for teen night, $15.00| DEBIT PURCHASE -VISA WALMART.COM 800-966-6546AR - smores supplies drink teen night, $42.00| DEBIT PURCHASE WM SUPERC Wal-MaTUMWATER WA, $36.00| DEBIT PURCHASE -VISA AMZING OUTLET CENTRALIA WA - sensory toys, $16.00| RECURRING DEBIT PURCHASE INSTANTNONPROFITHTTPSWWW.INSCO, $37.00| RECURRING DEBIT PURCHASE INTUIT *QBooks OCL.INTUIT.COCA, $16.00| DEBIT PURCHASE CASH & CARRY TUMWATER WA - Thanksgiving supplies, $25.00| DEBIT PURCHASE WM SUPERC Wal-MaTUMWATER WA - Thanksgiving supplies, $15.00| DEBIT PURCHASE -VISA AMZN Mktp US*NI6Amzn.com bilWA - warranty for propane heaters, $94.00| DEBIT PURCHASE THE HOME DEPOT 4CHEHALIS WA - pickets to enclose barn behind sign, $164.00| DEBIT PURCHASE -VISA AMZN Mktp US*T78Amzn.com bilWA - propane heaters, $602.00| DEBIT PURCHASE M SHAH LLC ROCHESTER WA propane for heaters, $9.00| DEBIT PURCHASE WAL-MART #3850 TUMWATER WA - Thanksgiving supplies, $220.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - Thanksgiving supplies, $40.00| DEBIT PURCHASE FRED-MEYE FRED MTUMWATER WA - Thanksgiving supplies, $61.00| DEBIT PURCHASE -VISA Amazon.com*QR2MPAmzn.com bilWA, $27.00| DEBIT PURCHASE COSTCO WHSE #006TUMWATER WA - Thanksgiving supplies, $22.00| DEBIT PURCHASE M SHAH LLC ROCHESTER WA propane for heaters for thanksgiving, $31.00| DEBIT PURCHASE -VISA GOEBEL SEPTIC TA360-736-2167WA, $400.00| RECURRI |
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